How important is l-arginine?

Perhaps more than any other supplement, l-arginine causes frustration and confusion. It’s difficult to find, sometimes quite expensive, and some preparations cause loose stools.

Just how necessary is it?

L-arginine, you’ll recall, is a source of nitric oxide, or NO. Though it’s the same stuff as in car exhaust, NO provides a critical signaling role in your body’s cells that regulate a multitude of functions. Among the important roles of NO is to powerfully dilate, or relax, arteries. A constant flow of NO is required for health, particularly since each molecule persists only a few seconds.

L-arginine is the body’s source of nitric oxide. In addition, a peculiar but very effective blocker of l-arginine called asymmetric dimethylarginine, or ASDM, has recently been discovered to prevent the production of NO. Varied conditions like hypertension, diabetes, high cholesterol, excessive saturated fat or processed carbohydrate intake all lead to heightened levels of ASDM, often several-fold greater levels, and thereby effectively blocking NO production.

The “Arginine Paradox” is the name that some researchers in this field have given to the unusual property of l-arginine supplementation to “overpower” the blocking effects of ASDM. This is somewhat unusual in biologic systems in that an agent that blocks a receptor cannot usually be outmuscled by providing excess material for a reaction. Kind of like hoping that your car runs faster simply by topping up the gas tank.

Concrete observable benefits have been made for l-arginine in clinical trials, such as arterial relaxation that results in arterial enlargement (which can actually be seen in the cath lab); anti-inflammatory effects; reduction of blood pressure; enhancement of insulin responses, etc. All of these effects can be connected to beneficial properties that may facilitate atherosclerotic plaque regression and, indeed, there are limited data to document that this is true.

Drug companies may be greedy, but they’re not stupid. They’ve been vigorously pursuing this line of research for some years, a research path that led inadvertently to the erectile dysfunction agent, sildenafil (Viagra), and all its subsequent competitors. (Erectile dysfunction is another expression of endothelial dysfunction, since male erections are driven by the ability to dilate penile arteries.) The wonderful properties of NO enhancement continue to occupy research labs around the world.

Wow. So what’s the reluctance? In the early years of the Track Your Plaque program (meaning just a short 7-8 years ago), I was thoroughly convinced that l-arginine was a crucial, necessary part of a plaque regression program. Without it, you would rarely succeed. With it, the odds were tipped in your favor.

However, something curious has emerged recently. I’ve seen more and more people dropping their heart scan scores. Not just a little bit, but a huge amount. Witness our most recent record holder, Neal, who dropped his score 51% in 15 months. Just five years ago, this magnitude of reversal was unimaginable. Granted, Neal is our record holder, but others are obtaining 10, 18, 24, 30% drops in scores all the time. Many have done it without l-arginine.

Now, how about the people who have failed to stop a rising score? Would they do better with l-arginine as part of the mix? I believe so, but sometimes we never quite know except in retrospect. It has been a great dilemma for us trying to predict from the starting gate who will or who won’t drop their heart scan score.

My view from the trenches is that l-arginine packs its greatest atherosclerosis-fighting punch in the first year or two of use, when “endothelial dysfunction” is likely to be present (abnormal artery constriction). But as all other strategies take hold—fish oil, correction of lipid and lipoprotein abnormalities, weight loss (big effect), vitamin D (another very big effect), etc.—endothelial behavior improves over time. Perhaps l-arginine becomes a less necessary component over time.

There’s no doubt that uncertainty still surrounds the use and science surrounding l-arginine. However, if you’re interested in stacking the odds in your favor, particularly during the first year or two of your plaque-reducing efforts, I think that l-arginine is worth considering. It is cumbersome, it can be expensive, some preparations may even be foul. But in the big picture of life, with hospitals trying every possible ploy to get your body on a table for a procedure, doctors perverting their mission by signing employment contracts with hospitals and agreeing to usher you into the hospital as a paying patient whenever possible, and drug companies viewing you and me as a market for medications which may or may not be helpful, l-arginine is surely not that big a burden.

Comments (13) -

  • Anonymous

    4/30/2007 6:39:00 PM |

    Are there any particular formulations of l-arginine that you are familiar enough with to recommend?

    There is such a bewildering array of supplements available; it is sometimes overwhelming to try to make an informed choice.

    Thank you

  • Dr. Davis

    5/1/2007 1:13:00 AM |

    The brand we've used most frequently for its relatively low cost and palatability is the PowerMaker II, available from Life Extension ( and I write articles for Life Extension but have no  interest beyond that with that organization. I have no relationship with Vitacost.

    Please also see my post from yesterday. We've been discussing such a list of recommendations. We resist the idea of selling supplements because of the corrupting effect of doing so, and the erosion of credibility. However, I believe that in future we can recommend/endorse/approve certain supplements without putting our integrity in doubt.

  • Chuck

    10/18/2007 10:44:00 AM |

    Dr D-
    So interesting to read your posts and excellent information! I will be a regular over here, and appreciate on a personal level everything you are commenting on, as I have been one of those *missed by the system* and am still out of range for the great docs that I am working with.

    Just got onto the arginine/endothelial recommendations from a different resource, and appreciate your heads up here on the practical matters of how to turn things around.

    We are on similar missions: over at I discuss a growing awareness of the real advances in neuroscience that often go overlooked in everyday psych care.

    Interestingly, folks think the heart and the brain are two different topics, and so often we see what you are talking about with the heart over here directly effecting brain recovery and brain health - with all of the positive emotional and cognitive benefits arriving right along with good heart scan tracking.

    Thanks again, look forward to talking one day,

  • Mystral

    10/26/2007 6:21:00 PM |

    Dear Dr Davis - was  most interested to read your input on L-Arginine - AAKG (Arginine Alpha-KetoGlutarate).  We have been running a trial on using AAKG on horses with the inflammatory systemic condition, ESPA (Equine Systemic Proteoglycans Accummulation) which is showing considerable success in treating the inflammation that this condition brings with it.  At the same time we also use the Jiaogulan (Gynostemma pentaphyllum) herb.  We are finding that the 'Jia' herb bolsters the effects of the AAKG by supressing the iNOS and supporting the eNOS.

    We have an enormous amount of information on this use on our yahoo groups list.  I should be most happy to direct your footsteps hence.

    I myself take AAKG + 'J' for control of hypertension and for the inflammation due to AS/OA/DDD.  It works very well indeed.

    I enjoy your blog spot, it is most interesting.  Thank you.


  • Rich

    11/25/2007 7:36:00 PM |

    I really have no adverse reaction to any supplement, except for two: magnesium and arginine. Magnesium is known to cause stomach distress, so I take a slow-release kind. As for arginine, I have tried to it several times, in different powder and slow-release formulations, and it eventually causes the following:
    -Stomach distress from powdered arginine
    -An unusual overstimulation from any kind of arginine, which manifests after a couple of days as pounding heartbeat (but not weakness),  slight anxiety, and difficulty sleeping. I know from extensive tests and from my vigorous daily workouts that there is no big problem with my heart that would cause this. It goes away when I stop the arginine. I can't believe that I'm the only person who experiences this effect.

  • Dr. Davis

    11/26/2007 12:53:00 AM |

    That is interesting.

    I suspect that there's an interesting lesson to be learned from your experience, but I'm unsure of what it is.

  • Anonymous

    12/28/2008 6:38:00 AM |

    I too experience the pounding heart from taking arginine- it finally dawned on me tonight that it must be the culprit.  I always notice it most when trying to get to sleep.  Frustrating!

  • Helena

    5/13/2009 4:38:00 PM |

    I just found your blog and it is very interesting! I am an Arginine-lover and truly believe that it can make a big difference in peoples lifes. I have taken Arginine (5 grams a day liquid formula)along with L-Citruline (250mg), omega fatty acids, EDTA, OPCs, vitamins, and other natural supplements since August of 2008 and Love it! I sleep better, have more energy, and can work out much better. I did however notice the heartbeating at bedtime my first few days or week when I started taking the product, like some of you also point out, but that went away by itself and I have not felt anything since then. I actually feel pretty darn good! My allegies have improved like crazy.

    Thank you for a good blog! / Helena

  • buy jeans

    11/3/2010 6:53:53 PM |

    The “Arginine Paradox” is the name that some researchers in this field have given to the unusual property of l-arginine supplementation to “overpower” the blocking effects of ASDM. This is somewhat unusual in biologic systems in that an agent that blocks a receptor cannot usually be outmuscled by providing excess material for a reaction. Kind of like hoping that your car runs faster simply by topping up the gas tank.

  • Nick

    1/5/2011 11:36:52 PM |

    Arginine is pretty important. Check

  • Richard

    5/26/2011 4:45:37 PM |

    I assure you guys are doing great. Thank you for managing this blog. You can make even money playing casino online

  • Bill

    6/3/2011 4:17:10 PM |

    Curious about your thoughts on NEO40. This Nitric Oxide supplement is touted as being Argenine free. I was given a sample this morning after a saliva test showed me slightly low for NO. I am not real sure about this supplement and have a relatively good BP, burn about 3500 calories a week through intense exercise, and eat a paleo style diet. Several years ago my cholesterol was 'high' but is now within clinical guidelines.

    So, will I benefit from this product or one like it?

    Love the blog and the information.


  • zails

    7/15/2014 10:13:53 PM |

    Been on l arginine 2 weeks ,,,my blood pressure is great now ,,,,so glad I found out about this natural supplement ,,blood pressure meds had so many horrible side effects...

Where do Track Your Plaque membership revenues go?

Where do Track Your Plaque membership revenues go?

People pay about $90 per year to become Members on the Track Your Plaque website. This provide access to our in-depth Special Reports, guides, webinars, and our proprietary software data tracking tools. Members can also participate in online discussions, such as those in the Track Your Plaque Forum and chats.

Why is there a charge for membership in the program and where does the money go?

Money raised from membership fees goes towards:

1) The costs of doing business, e.g., server fees, software purchases, legal fees. Hosting webinars, for instance, costs us about $99 per month for the GoToWebinar software service.

2) Software development--Our most recent round of software data tracking tools, for instance, cost us nearly $30,000. That may not be a lot from big business standards, but it is onerous enough that obtaining membership dues really helps.

3) Graphics development--A website without graphics would be awfully dull, regardless of the quality of the textual content. Some of the newest tools on the Track Your Plaque website require photography and graphics work, which can add up very quickly.

Where membership fees do NOT go:

1) In our pockets--In fact, except for the various contractors who are paid for their services (e.g., software developers), NOBODY on the Track Your Plaque staff are paid: not me, nor any of the behind-the-scenes staff. Some of the staff overlap with my office staff, but they are paid purely out of the office revenues, not out of Track Your Plaque membership dues.

2) Towards overhead costs beyond those listed above--For example, membership fees do not pay for office lease, utilities, phones, etc.

We rely on membership fees because we have chosen to remain as free of commercial bias as possible. We host no advertising, we have no behind-the-scenes corporate or institutional agendas, we show no favoritism to any business or commercial operation. We believe this permits editorial freedom that few other health websites can enjoy. (In fact, I know of no other that is so free of commercial bias, outside of small blogs or narrow-interest websites.)

If you want to see what damage commercial bias can create, just go to a health website like WebMD. I challenge you to find information that is not flagrantly biased by commercial influence, namely that of the drug industry. (According to the WebMD SEC filings, in fact, the great majority--approximately 80%--of their $331 million revenues (2007) were derived directly or indirectly from the drug industry.) This commercial bias reaches into all of WebMD's related businesses, including,,, and several others.

Preventing heart disease is not a money maker, sad to say. It is, from the perspective of conventional heart care, a big money loser. Undergo a heart catheterization, hospitalization, stent or bypass for anywhere from $14,000 to well over $100,000---or pay $90 for in-depth health information that dramatically reduces the potential need for the hospital and its procedures, minimizes need for prescription medication (statins alone, of course, are a $27 billion annual revenue phenomenon), and achieves all this by maximizing nutrition, self-purchased nutritional supplements, and inexpensive heart scans. Nobody is going to make a bundle off of this approach.

So that is why we charge a membership fee. I often get a laugh from some of the comments of people on this blog or even in my office who believe that we are rolling in money from the website from membership dues. The opposite is true: We don't pay ourselves. Virtually every penny is reinvested back into the website to better serve the Members.

Comments (9) -

  • steve

    12/26/2008 6:29:00 PM |

    aren't you coming out with a new edition of your book?  Clearly it will be cheaper than a yearly membership, and hopefully will contain all the info. shown on TYP membership site; otherwise it would be in some respects short changing the reader. Why not just buy the updated book to get current info at less expensive price?

  • virginia

    12/27/2008 5:01:00 AM |

    thanks. i have linked you via my blog...found you at fanaticcook.

  • Bob Parks

    12/27/2008 6:20:00 PM |

    you wrote:

    "approximately 80%--of their $331 revenues (2007)"

    That has to be a typo, $331 million maybe?


  • Anonymous

    12/27/2008 6:23:00 PM |

    The dues I've paid to be a TYP member, and the wealth of unbiased and cutting edge information I've derived there from, are  some of the BEST preventive healthcare dollars I could have spent.

    My co-pays for a stay in the hospital or trip to the cath lab could pay for many years of membership in TYP.  My bet is that the information I've derived from Track Your Plaque will keep me away from those scary places... or give me my best shot if I should ever have to go there.

    To my knowledge, there is no other website that provides such a wealth of information, and the tools to use it, for such a low subscription fee.

    Dr. Davis you do an extraordinary job with the TYP website, thank you for all you do!  Your work is sincerely appreciated.

    Happy New Year to you, and to Track Your Plaque website staff and members.

    Houston, TX

  • Richard Nikoley

    12/27/2008 8:25:00 PM |

    For what it's worth, Doc Davis, I never had a doubt.

    Not that it would have mattered anyway. Would that the financial rewards went to those most and not least deserving and that such would be welcomed with open arms by the beneficiaries of your revolutionary, life-saving approach.

    I salute you, sir.

  • Dr. William Davis

    12/29/2008 1:39:00 AM |

    Thanks for catching that, Bob.

  • Anonymous

    12/29/2008 4:34:00 AM |

    Please keep the fee high enough to keep the information unbiased and to keep out those who do not understand the power of the information and would dilute the message.

  • Anonymous

    12/29/2008 5:30:00 AM |

    Steve, the Track Your Plaque book and the Track Your Plaque website are two quite different things.

    I have the first edition of the TYP book (and have given away copies to friends who discovered they have coronary artery disease). I have been a TYP member for some time. I also intend to buy the new edition of the book when it is out (and I will continue to give out copies to people I know who discover they have CAD).

    The new Track Your Plaque book will have Dr. Davis' updated observations, the latest (evolved) version of the program, and more, and should be current, at least as of the date of publication.

    The Track Your Plaque website is both comprehensive and interactive:  The latest aspects of the program are there, as well as extensive information and articles about each aspect of TYP strategies, AND it will be updated over time as new strategies evolve.  In addition there are new interactive tools to track your blood work and tell you how well you are doing with your program and your heart scan scores.  There are also wonderful forums where TYP members can post questions, and receive information and advice from other members, as well as Dr. Davis and some of his staff, in a very supportive atmosphere.

    There is nothing like the TYP membership website, not even a brand new updated edition of the TYP book, and it is, for my money, a bargain.

    Hope this helps!


  • pamojja

    11/15/2009 3:57:47 PM |

    are there other options to join TrackYourPlaque other than with credit cards?

    I don't want to get one for just this purpose, especially not in times of the big credit crunch.

    Thanks for any suggestions.